By Jamshid Tehranzadeh
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Additional info for Musculoskeletal imaging cases
Full thickness retracted supraspinatus tear (white arrow) and ﬂuid extravasating from joint, through cuff into AC joint (arrowhead). C. Geyser phenomenon: Sagittal fat-saturated T2-weighted image shows bursa (black arrow), ﬂuid entering AC joint (arrowhead), and tear of infraspinatus tendon, partial (white arrow). D. Geyser phenomenon: Sagittal fat-saturated T2-weighted image shows bursa (black arrow), ﬂuid entering AC joint (arrowhead), and tear of infraspinatus tendon, partial (white arrow). IMAGE KEY Common DIFFERENTIAL DIAGNOSES IMAGES Rare Typical E.
DIFFERENTIAL DIAGNOSES • Parsonage-turner syndrome: A rare condition characterized by inﬂammation of the lower motor neurons of the brachial plexus innervating the muscles of the chest, shoulders, and arms. • Labral cyst: Ganglion cysts of the shoulder that may cause suprascapular entrapment neuropathy resulting in shoulder pain and infraspinatus muscle weakness. COMMENTS The quadrilateral space syndrome is musculotendinous formation bounded by the teres minor muscle (superiorly), the teres major muscle (inferiorly), the Humerus (laterally), and the long head of triceps (medially).
The articular surface of the cuff to the subacromial/subdeltoid bursa. In chronic cuff tears where the shoulder joint has little or no effusion, the humeral head may be high riding such that little high signal is seen at the tear site. Acute tears can have hemorrhage at the tear site that can mimic some intact ﬁbers. It is important to distinguish the smoothly curving, low-signal surfaces of the cuff from the disorganized low signal of ﬁbrin and other blood products. Partial tears often appear on T1-weighted image as intermediate signal, isointense to muscle, which is bright on T2-weighted image; however, it does not fully extend from articular surface to subacromial subdeltoid bursa.